Changes in Perceived Discrimination and Its Effects on Service Use and Alternative Help Seeking Behaviors
Methods. Analyses included data from the baseline (1995) and follow-up (2004) studies of the Midlife in the US (MIDUS) cohort study. MIDUS is a stratified, multistage probability sample of community-based, English-speaking adults aged 25–74 years.
Perceived day-to-day experiences of discrimination were measured using the 9-item version of the Interpersonal Discrimination Scale constructed by Williams et al. (1981). A categorical variable with 4 groups was created to characterize changes in discrimination. The following schema was used: 1) no change from the first or second lowest quartiles in both waves (low-stable); 2) movement from a higher to a lower quartile in wave I to wave II (decrease); 3) movement from a lower quartile to a higher quartile (increase); and 4) no change from the third and fourth highest quartiles in both waves (high-stable).
Conventional Health Service Use was a count of the number of times the respondent saw a doctor, hospital, or clinic for a routine visit. Conventional Mental Health Service Use referred to visits to mental health providers in the past 12 months. Alternative help-seeking of mindfulness referred to the use of yoga, tai chi, meditation, or relaxation exercises in the past 12 months.
Results. The sample was classified as follows: Low-Stable (n=1876, 41.55%), Decrease (n=392, 8.68%), Increase (n=1175, 26.02%), and High-Stable (n=1072, 23.74%). High-Stable and Increase groups included morepeople of color (X2 =153.893, p<.001), while the Low-Stable group consisted of more White respondents. African American respondents belonged to the High-Stable group. Low-Stable groups reported better physical (F=6.85, p<.001) and emotional health (F=8.48, p<.001), compared to High-Stable and Increase groups.
While the use of health and mental health services has increased over the time period of a decade, changes in the frequency of seeking conventional health services is not statistically significant. Increase in seeking mindfulness in the same time periods were significant (F =3.27, p<.05).
The step-wise dummy regression analysis was conducted using the Low-Stable as a reference group. Compared to the Low-Stable group, High-Stable members reported significant increases in conventional health services including medical doctors (t =4.204, p<.001) and mental health professionals (t =4.837, p < .001). For both Increase and Decrease groups, the changes in their use of conventional health and mental health services were not significant, compared to the Low-Stable groups. As for using the alternative modality of mindfulness, all three groups---Increase (t =3.190, p< .001), Decrease (t =2.349, p< .001), and High-Stable (t =10.197, p<.001) reported using this alternative method significantly more than the Low-Stable groups
Implications. Perceived interpersonal discrimination impacted the types of help seeking behaviors used by adults. With the increasing popularity of mindfulness in the US, further research is needed to examine the broader context in which these are practiced as alternative help seeking behaviors.